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Evidence-based Low Intensity Treatments for Common Mental Health Problems

Module description

A range of low intensity cognitive behavioural interventions are recommended by NICE for the treatment of patients with mild-to-moderate common mental health problems, and are presented and used in a variety of methods used by different services and practitioners. The overall delivery of these interventions is informed by COM-B behaviour change models and strategies. Examples of interventions include providing support for a range of low-intensity self-help interventions (often with the use of written self-help materials) informed by cognitive-behavioural principles, such as behavioural activation, exposure, cognitive restructuring, panic management, problem solving, CBT-informed sleep management, and computerised cognitive behavioural therapy (cCBT) packages as well as supporting physical exercise and medication adherence.

In this module you will gain competency in recognising appropriate interventions from those available, an appreciation of what makes a good self-help resource, develop key skills in motivating and supporting the use of self-help materials with step 2 patients. You will learn how to identify common problems arising and support patients’ use of these interventions, and you will learn about motivational interviewing and continue your skills around the COM-B model to aid this process. You will also gain knowledge and competencies required to support medication concordance. The module will also equip you with the knowledge and skills to deliver interventions individually through face-to-face, telephone, video, email or other contact methods, and also develop your skills in group delivery. You will learn how to end treatment with relapse prevention. A heavy focus upon clinical skills teaching will enhance your general and disorder-defined ‘specific factors’ competencies in support of these interventions, including ongoing review and management of risk and use of outcome monitoring metrics.

Module aims - intentions of the module

The aim of this module is to provide you with a good understanding of the process of therapeutic support for a range of evidence-based, low intensity cognitive behavioural interventions and to manage the learning and development of individuals and groups of patients.

Intended Learning Outcomes (ILOs)

ILO: Module-specific skills

On successfully completing the module you will be able to...

• 1. Critically evaluate a range of evidence-based interventions and strategies to assist patients manage their emotional distress and disturbance, to a level appropriate to Level 6
• 2. Demonstrate competency in maintaining a therapeutic alliance with patients during their treatment programme, including dealing with issues and events that threaten the alliance
• 3. Plan competently a collaborative low-intensity psychological treatment programme for common mental health problems, including managing the ending of contact and relapse prevention strategies
• 4. Describe in depth and use competently a range of low-intensity, evidence-based psychological interventions for common mental health problems
• 5. Use competently COM-B behaviour change models and strategies in the delivery of low-intensity interventions
• 6. Critically evaluate the role of case management and stepped care approaches to managing common mental health problems in primary care including ongoing risk management appropriate to service protocols and NICE guidance
• 7. Support people with medication for common mental disorders to help them optimise their use of pharmacological treatment and minimise any adverse effects
• 8. Deliver low-intensity interventions using a range of methods including face-to-face, telephone and electronic communication, and in groups, revising the suitability of mode of delivery as necessary

ILO: Discipline-specific skills

On successfully completing the module you will be able to...

• 9. Summarise basic and essential factual and conceptual knowledge of the subject, and demonstrate a critical understanding of this knowledge, to a level appropriate to Level 6
• 10. Review and evaluate established work and identify some of the strengths and weaknesses of this work, to a level appropriate to Level 6

ILO: Personal and key skills

On successfully completing the module you will be able to...

• 11. Record accurately interviews and questionnaire assessments using paper and electronic record-keeping systems
• 12. Evaluate your strengths and weaknesses, challenge received opinion and develop your own criteria and judgement, and to seek and make use of feedback

Syllabus plan

The module content, module-specific learning objectives, style of delivery and assessment for this module are as informed by the HEE 4^th Edition (2022) revised curriculum for the training of Psychological Wellbeing Practitioners to support the delivery of low intensity CBT associated with NHS Talking Therapies services. Teaching content will include:

Evidence-based interventions and strategies

• Developing and maintaining a therapeutic alliance
• Dealing with issues and events that disrupt the alliance – engaging patients
• Motivational interviewing
• Use of the COM-B model
• Supporting use of low intensity or pharmacological treatments
• Competence in introducing low intensity interventions (intervention specific and problem specific)
• Recognising common problems encountered by patients when using interventions
• Knowledge of the theory and various models:
  • Behavioural Activation
  • Problem Solving
  • Exposure
  • Sleep Management
  • Cognitive Restructuring/Behavioural Experiments
  • Panic Management
  • Dealing with Worry
  • Medication Management

Context of delivery

• Case management
• Stepped care
• Risk management
• Supporting low intensity interventions (face-to-face, telephone, e-mail, group work)

Learning activities and teaching methods (given in hours of study time)

Details of learning activities and teaching methods

Formative assessment

Summative assessment (% of credit)

Details of summative assessment

Details of re-assessment (where required by referral or deferral)

Re-assessment notes

Three assessments are required for this module. In all cases re-assessment will be the same as the original assessment. Where you have been referred/deferred for any form of assessment detailed above you will have the opportunity to retake within four weeks from the date that feedback was provided, or a date determined in partnership with you and your service on the basis of agreed action plan for Clinical Practice Outcomes.

If you pass re-assessments taken as a result of deferral, your re-assessment will be treated as it would be if it were your first attempt at the assessment and the overall module mark will not be capped.

If you pass re-assessments taken as a result of referral (i.e. following initial failure in the assessment), the individual assessment is capped at the pass mark and the overall module mark will be capped at 40%.

If you fail re-assessments taken as a result of referral (i.e. following initial failure in the assessment), you will be failed in the module and as a consequence you will be failed in the programme and your registration as a student of the University will be terminated.

Indicative learning resources - Basic reading

Core reading:

• Bennett-Levy, J., Richards, D., Farrand, P. et al (2010). Oxford Guide to Low Intensity CBT Interventions. Oxford: Oxford University Press.
• Bennett-Levy, J., Thwaites, R., Haarhoff, B. & Perry, H. (2015). Experiencing CBT from the Inside Out: A Self-Practice/Self-Reflection Workbook for Therapists. Guilford, New York.
• Farrand, P. (2020). Low-Intensity CBT Skills and Interventions. London: SAGE.
• Silverman, J., Kurtz, S. and Draper, J. (2005). Skills for Communicating with Patients. Oxford: Radcliffe.
• NCCMH. (2023). The Improving Access to Psychological Therapies Manual.
• Papworth, M. & Marrinan, T. (2019). Low intensity cognitive behaviour therapy: A practitioner’s guide. Los Angeles: SAGE.
• Richards, D & Whyte, M. (2011). Reach Out Manual, 3^rd Edition. London: Rethink Mental Illness.

Wider reading:

• Farrand, P. and Woodford, J. (2013). Impact of support on the effectiveness of written cognitive behavioural self-help: a systematic review and meta-analysis of randomised controlled trials. Clinical Psychology Review, 33(1), 182-195
• Westbrook, D., Kennerley, H. & Kirk, J (2007). An introduction to cognitive behaviour therapy: skills and applications. 
• Lovell, K. and Richards, D. (2008). A Recovery Programme for Depression. London: Rethink Mental Illness.
• Richards, D. A., Rhodes, S., Ekers, D., McMillan, D., Taylor, R. S., Byford, S., et al. (2017). Cost and Outcome of Behavioural Activation (COBRA): a randomised controlled trial of behavioural activation versus cognitive behavioural therapy for depression. Health Technology Assessment 21 (46).
• NICE (2011). Common Mental Health Disorders: Identification and Pathways to Care. Clinical Guideline 123. London: NICE

Key words search

Improving Access to Psychological Therapies, IAPT, NHS Talking Therapies, low intensity, cognitive behavioural therapy, common mental health problems, primary care, evidence based psychological therapies, clinical competency